P-gp、GSTπ联合TOPOⅡα检测对三阴性乳腺癌新辅助化疗病理完全缓解的预测价值  

Predictive value of P⁃gp,GSTπcombined with TOPOⅡαdetection for pathological complete response to neoadjuvant chemotherapy in triple⁃negative breast cancer

作　　者：吕宁 王芳[1] 陈卓[1] LV Ning;WANG Fang;CHEN Zhuo(Department of Breast Surgery,the First Affiliated Hospital of Zhengzhou University,Zhengzhou,Henan,China,450000)

机构地区：[1]郑州大学第一附属医院乳腺外科,河南郑州450000

出　　处：《分子诊断与治疗杂志》2024年第3期412-415,420,共5页Journal of Molecular Diagnostics and Therapy

基　　金：河南省医学科技攻关计划项目(201702016)。

摘　　要：目的分析P⁃糖蛋白(P⁃gp)、谷胱甘肽转移酶(GSTπ)联合拓扑异构酶Ⅱα(TOPOⅡα)检测对三阴性乳腺癌(TNBC)患者新辅助化疗(NAC)病理完全缓解(pCR)的预测价值。方法本研究为一项回顾性、单中心、双盲法的试验,选取郑州大学第一附属医院自2020年3月至2022年10月,经纳入、排除标准共筛查135名TNBC患者作为研究对象,均为女性。采用SP免疫组化法检测P⁃gp、GSTπ、TOPOⅡα,分析TNBC患者NAC疗效,行单因素、多因素分析P⁃gp、GSTπ、TOPOⅡα表达与NAC pCR的关系,绘制ROC曲线分析P⁃gp、GSTπ、TOPOⅡα单一及联合检测对TNBC患者NAC pCR的预测价值。结果NAC后,cCR者47例(34.81%),cPR者72例(53.33%),SD者12例(8.90%),PD者4例(2.96%),总有效率88.14%;pCR者21例(15.55%)。经单因素分析,P⁃gp、GSTπ阳性表达pCR率低于P⁃gp、GSTπ阴性表达pCR率,TOPOⅡα阳性表达pCR率则高于阴性性表达pCR率,差异均有统计学意义(P<0.05)。P⁃gp、GSTπ、TOPOⅡα表达与pCR具有显著相关性[OR(95%CI)分别为1.446(1.127~1.858)、1.640(1.304~2.063)、1.548(1.227~1.984),P<0.05]。P⁃gp、GSTπ、TOPOⅡα联合检测对NAC pCR灵敏度、特异度分别为90.73%、86.73%,AUC(95%CI)为0.813(0.743~0.908),均高于上述指标单一检测(P<0.05)。结论P⁃gp、GSTπ和TOPOⅡα表达与TNBC患者NAC pCR有一定关联,且通过联合上述指标检测NAC pCR有着较高预测价值,有利于帮助临床医生为TNBC患者进一步制定更合适的治疗策略。Objective To analyze the predictive value of P-glycoprotein(P-gp),glutathione transferase(GSTπ)combined with topoisomerase IIα(TOPO IIα)assay for pathological complete remission(pCR)of neoadjuvant chemotherapy(NAC)in patients with triple negative breast cancer(TNBC).Meth-ods This study is a retrospective,single-center,double-blind trial.A total of 135 TNBC patients,all fe-male,were selected from the First Affiliated Hospital of Zhengzhou University from March 2020 to October 2022 and screened according to the inclusion and exclusion criteria.SP immunohistochemistry was used to de-tect P-gp,GSTπ,and TOPOⅡαto analyze the efficacy of NAC in TNBC patients,and single and multifacto-rial analyses were performed to analyze the relationship between the expression status of P-gp,GSTπ,and TOPOⅡαand NAC pCR.ROC curves were plotted to analyze the predictive value of P-gp,GSTπ,and TOPOⅡαsingle and combined assays on NAC pCR in TNBC patients.Results After NAC,47 cases(34.81%)achieved complete clinical response(cCR),72 cases(53.33%)achieved partial cPR,12 cases(8.90%)had SD,and 4 cases(2.96%)had PD.The total effective rate was 88.14%.with 21 cases(15.55%) achieving pCR.Following NAC,21 cases(15.55%)achieved pCR,in univariate analysis,the pCR rate was lower for positive expression of P-gp and GSTπcompared to expression,while the pCR rate of positive expres-sion of TOPOⅡαcompared to negative expression,with statistically significant differences(P<0.05).P-gp,GSTπ,and TOPOⅡαexpression were significantly associated with pCR[OR(95%CI)1.446(1.127~1.858),1.640(1.304~2.063),and 1.548(1.227~1.984),respectively,(P<0.05)].The sensitivity and specificity of com-bined detection of P-gp,GSTπ,and TOPOⅡαfor NAC pCR were 90.73%and 86.73%,respectively,with an AUC(95%CI)of 0.813(0.743-0.908);all of which were higher than single detection of theseindicators(P<0.05).Conclusion The expression of P-gp,GSTπand TOPOⅡαwas found to be correlated with NAC pCR in TNBC patients.Combining the above indicators for the detection o

关 键 词：P-糖蛋白 拓扑异构酶Ⅱα 谷胱甘肽转移酶 三阴性乳腺癌 新辅助化疗 

分 类 号：R737.9[医药卫生—肿瘤]